AB0784 Symptoms compatible with Rome IV functional bowel disorder in patients with ankylosing spondylitis
Authors: L. Wang, C. Song, Y. Wang, L. Hu, X. Liu, J. Zhang, X. Ji, S. Man, Y. Yang, L. Peng, Z. Wei, F. Huang
Journal: Annals of the Rheumatic Diseases (2022)

Background Clinical manifestations of gut problems except for inflammatory bowel disease (IBD) have not been well-established in patients with ankylosing spondylitis (AS). One study investigated that 30% patients with axial spondyloarthritis (axSpA) had irritable bowel syndrome (IBS) symptoms meeting Rome III criteria.[1] Objectives To determine the frequency of symptoms meeting Rome IV functional bowel disorder (FBD) in patients with AS, investigate factors associated with FBD symptoms, and assess whether having FBD symptoms might influence AS disease activity. Methods In this cross-sectional study, we consecutively enrolled 153 AS patients without known colonic ulcer and 56 sex- and age-matched controls to evaluate FBD (or its subtypes) symptoms.[2] In AS group, logistic regression models were used to explore whether demographic data, disease activity, level of gut inflammation, drug use, and fibromyalgia [3] were associated with presence of gut symptoms. Finally, potential impacts of gut symptoms on AS disease status were assessed in linear regression models. Results Sixty (39.2%) of 153 AS patients had FBD symptoms, which was more prevalent than controls (23.2%). Besides, symptoms compatible with IBS and chronic diarrhea were detected in 18 and 43 AS patients respectively. For AS group, multivariable logistic regression analyses showed that symptoms of FBD, IBS, and chronic diarrhea were negatively associated with using non-steroidal anti-inflammatory drug (NSAID), and positively associated with comorbid fibromyalgia, respectively. In exploration about effects of FBD (or its subtypes) symptoms on AS disease activity by multivariable linear regression analyses, FBD symptoms and chronic diarrhea had positive associations with assessments of AS respectively. Conclusion Patients with AS had frequent symptoms compatible with FBD, IBS, and chronic diarrhea, proportions of which were lower in those with NSAID-use. The improvement of FBD symptoms, especially chronic diarrhea, might be conducive to disease status of AS patients. References [1]Wallman JK, et al. Ann Rheum Dis. 2020;79:159-61. [2]Mearin F, et al. Gastroenterology. 2016;18:S0016-5085(16)00222-5. [3]Wolfe F, et al. J Rheumatol. 2011;38:1113-22. Figure 1. Frequencies with symptoms meeting FBD criteria Table 1. Univariable and multivariable associations between gut symptoms and assessments of AS Gut symptoms Univariable Multivariable β p β p ASDAS-CRP a FBD symptoms 0.234 0.112 0.294 &lt; 0.001 IBS symptoms 0.039 0.863 Chronic diarrhea 0.217 0.172 0.301 0.002 BASDAI b FBD symptoms 0.747 &lt; 0.001 0.764 &lt; 0.001 IBS symptoms 0.202 0.560 Chronic diarrhea 0.761 0.002 0.845 &lt; 0.001 BAS-G c FBD symptoms 0.936 &lt; 0.001 0.979 &lt; 0.001 IBS symptoms 0.059 0.889 Chronic diarrhea 0.903 0.003 0.949 0.001 ASAS HI d FBD symptoms 1.941 &lt; 0.001 1.673 0.003 IBS symptoms 2.263 0.008 1.769 0.046 Chronic diarrhea 1.500 0.015 1.343 0.030 BASFI e FBD symptoms 0.433 0.049 0.428 0.048 IBS symptoms 0.296 0.376 Chronic diarrhea 0.448 0.060 0.425 0.069 BASMI f FBD symptoms -0.373 0.190 -0.493 0.075 IBS symptoms -0.442 0.304 Chronic diarrhea -0.179 0.564 Besides gut symptoms, other clinical variables (Block-1) being chosen into hierarchical multivariable models were as follows: a HLA-B27, lnCRP, and lnESR; b HLA-B27 and lnESR; c HLA-B27 and lnCRP; d sex and TNFi; e HLA-B27, lnESR, and TNFi; f age and lnESR. Missing data ranging from 1-7%. Disclosure of Interests None declared